Using digital technology for home monitoring, adherence and self-management in cystic fibrosis: a state-of-the-art review

Abstract

Digital healthcare is a rapidly growing healthcare sector. Its importance has been recognised at both national and international level, with the WHO recently publishing its first global strategy for digital health. The use of digital technology within cystic fibrosis (CF) has also increased. CF is a chronic, life-limiting condition, in which the treatment burden is high and treatment regimens are not static. Digital technologies present an opportunity to support the lives of people with CF. We included 59 articles and protocols in this state-of-the-art review, relating to 48 studies from 1999 until 2019. This provides a comprehensive overview of the expansion and evolution of the use of digital technology. Technology has been used with the aim of increasing accessibility to healthcare, earlier detection of pulmonary exacerbations and objective electronic adherence monitoring. It may also be used to promote adherence and self-management through education, treatment management Apps and social media.

What effective ways of motivation, support and technologies help people with cystic fibrosis improve and sustain adherence to treatment?

“…Home monitoring, trials involving physiotherapy and virtual clinics were also identified, although these have previously been used in trials in CF. 20 …”

The Impact of the China-Pakistan Economic Corridor on Pakistan’s Federal System

“…8 Its use in CF has increased over the last 20 years yet there is currently limited evidence of its efficacy in improving long-term adherence in CF. 20 This study has highlighted that although technology is being used by a group within the CF community to aid treatment management; it is promoted more by HCPs than used in practice by the majority of pwCF at present. 21 In addition, the types of technologies preferred by pwCF can be different to what is recommended by their HCPs.…”

“…Home monitoring, trials involving physiotherapy and virtual clinics were also identified, although these have previously been used in trials in CF. 20 Ongoing studies including CFHealthHub 12 and Project Fizzyo 13 aim to address adherence in CF through the use of digital technology. Project Fizzyo combines the use of Fitbit exercise trackers with chipped airway clearance Open access devices with feedback given on technique via an App.…”

Using telehealth to assess depression and suicide ideation and provide mental health interventions to groups of chronically ill adolescents and young adults

“…Additionally, our iPad‐based group interventions were without the demands of travel or exposure to many of the common health infection risks that HPN patients encounter in clinic visits. Systematic reviews, meta‐analyses, and evaluations of Internet‐delivered interventions, including groups, have shown positive results in improving mental health of adolescents and young adults (Calthorpe et al, 2020; Nelson et al, 2006; Rogers et al, 2017). In one clinical trial using telehealth videophones, the young subjects' depression improved at a faster rate and parents reported fewer disruptive behaviors than families in outpatient group visits with controls matched on age and length of symptoms (Nelson & Duncan, 2015).…”

“…Technical challenges with distance care have been written about previously (Calthorpe et al, 2020; Smith et al, 2015). These challenges include the occasional dropped or slow connections, pixel blurring, and the need for online security.…”